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Shi Y, Zhang Z, Wang B, Wang Y, Kong X, Sun Y, Li A, Cui Y, Zhang Y, Li J, Huo Y, Huang H. Effect of plateletcrit and methylenetetrahydrofolate reductase (MTHFR) C677T genotypes on folic acid efficacy in stroke prevention. Signal Transduct Target Ther 2024; 9:110. [PMID: 38724491 PMCID: PMC11082186 DOI: 10.1038/s41392-024-01817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/21/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
Previous studies have shown that low platelet count combined with high plasma total homocysteine (tHcy) increased stroke risk and can be lowered by 73% with folic acid. However, the combined role of other platelet activation parameters and the methylenetetrahydrofolate reductase (MTHFR) C677T genotypes on stroke risk and folic acid treatment benefit remain to be examined. This study aimed to investigate if platelet activation parameters and MTHFR genotypes jointly impact folic acid treatment efficacy in first stroke prevention. Data were derived from the China Stroke Primary Prevention Trial. This study includes a total of 11,185 adult hypertensive patients with relevant platelet activation parameters and MTHFR genotype data. When simultaneously considering both platelet activation parameters (plateletcrit, platelet count, mean platelet volume, platelet distribution width) and MTHFR genotypes, patients with both low plateletcrit (Q1) and the TT genotype had the highest stroke incidence rate (5.6%) in the enalapril group. This subgroup significantly benefited from folic acid treatment, with a 66% reduction in first stroke (HR: 0.34; 95% CI: 0.14-0.82; p = 0.016). Consistently, the subgroup with low plateletcrit (Q1) and the CC/CT genotype also benefited from folic acid treatment (HR: 0.40; 95% CI: 0.23-0.70; p = 0.001). In Chinese hypertensive adults, low plateletcrit can identify those who may greatly benefit from folic acid treatment, in particular, those with the TT genotype, a subpopulation known to have the highest stroke risk.
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Grants
- This work was supported by the National Nature Science Foundation of China (82061160372, 82270771), the National Key Research and Development Program (2020YFC2004405), the Shenzhen Key Laboratory of Precision Prevention and Control of Major Chronic Diseases and Metabolic Research (ZDSYS20220606100801004), the Central Military Commission Key Project of Basic Research for Application (BWJ21J003), the Regional Joint Funding Key Project of Guangdong Basic Research and Basic Research for Application (2021B1515120083), the Key Project of Sustainable Development Science and Technology of Shenzhen Science and Technology Innovation Committee (KCXFZ20211020163801002), the Sun Yat-sen University-Shenzhen TAILORED Medical Ltd. Postgraduate joint training base, the Futian District Public Health Scientific Research Project of Shenzhen (FTWS2022001), the Chinese Association of Integrative Medicine-Shanghai Hutchison Pharmaceuticals Fund (HMPE202202), and the Shenzhen Key Medical Discipline Construction Fund (SZXK002) to Hui Huang. The fifth "333" high-level talent training project of Jiangsu Province (BRA2019247). Medical Research Project of Jiangsu Provincial Health Commission in 2020 (ZDA2020018).
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Affiliation(s)
- Yuncong Shi
- Cardiovascular Department, The Eighth Affiliated Hospital, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, Sun Yat-sen University, Shenzhen, China
| | - Zhengzhipeng Zhang
- Cardiovascular Department, The Eighth Affiliated Hospital, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, Sun Yat-sen University, Shenzhen, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yu Wang
- Shenzhen Tailored Medical Laboratory, Shenzhen, China
| | - Xiangyi Kong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yong Sun
- Department of Neurosurgery, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
| | - Aimin Li
- Department of Neurosurgery, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, China
| | - Yimin Cui
- Institute of Clinical Pharmacology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Hui Huang
- Cardiovascular Department, The Eighth Affiliated Hospital, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, Sun Yat-sen University, Shenzhen, China.
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2
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He Q, Wei Y, Zhu H, Liang Q, Chen P, Li S, Song Y, Liu L, Wang B, Xu X, Dong Y. The combined effect of MTHFR C677T and A1298C polymorphisms on the risk of digestive system cancer among a hypertensive population. Discov Oncol 2024; 15:97. [PMID: 38565713 PMCID: PMC10987447 DOI: 10.1007/s12672-024-00960-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 03/29/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND PURPOSE The enzyme methylenetetrahydrofolate reductase (MTHFR) plays a crucial role in directing folate species towards nucleotide synthesis or DNA methylation. The MTHFR polymorphisms C677T and A1298C have been linked to cancer susceptibility, but the evidence supporting this association has been equivocal. To investigate the individual and joint associations between MTHFR C677T, A1298C, and digestive system cancer in a Chinese hypertensive population, we conducted a population-based case-control study involving 751 digestive system cancer cases and one-to-one matched controls from the China H-type Hypertension Registry Study (CHHRS). METHODS We utilized the conditional logistic regression model to evaluate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) of digestive system cancer. RESULTS The analysis revealed a significantly lower risk of digestive system cancer in individuals with the CT genotype (adjusted OR: 0.71; 95% CI 0.52, 0.97; P = 0.034) and TT genotype (adjusted OR: 0.57; 95% CI 0.40, 0.82; P = 0.003; P for trend = 0.003) compared to those with the 677CC genotype. Although A1298C did not show a measurable association with digestive system cancer risk, further stratification of 677CT genotype carriers by A1298C homozygotes (AA) and heterozygotes (AC) revealed a distinct trend within these subgroups. CONCLUSION These findings indicate a potential protective effect against digestive system cancer associated with the T allele of MTHFR C677T. Moreover, we observed that the presence of different combinations of MTHFR polymorphisms may contribute to varying susceptibilities to digestive system cancer.
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Affiliation(s)
- Qiangqiang He
- Shenzhen International Graduate School, Tsinghua University, University Town of Shenzhen, No. 2279, Lishui Road. Nanshan District, Shenzhen, 518055, Guangdong, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, Guangdong, China
| | - Yaping Wei
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Hehao Zhu
- School of Science, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Qiongyue Liang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
- Inspection and Testing Center, Key Laboratory of Cancer FSMP for State Market Regulation, Shenzhen, 518057, China
| | - Shuqun Li
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China
| | - Yun Song
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, Guangdong, China
| | - Lishun Liu
- Shenzhen International Graduate School, Tsinghua University, University Town of Shenzhen, No. 2279, Lishui Road. Nanshan District, Shenzhen, 518055, Guangdong, China
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, Guangdong, China
- Guangdong Key Laboratory of H-Type Hypertension and Stroke Precision Prevention Research and Development Enterprise, Shenzhen, 518057, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, 518057, Guangdong, China
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health, Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Yuhan Dong
- Shenzhen International Graduate School, Tsinghua University, University Town of Shenzhen, No. 2279, Lishui Road. Nanshan District, Shenzhen, 518055, Guangdong, China.
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Bjørke-Monsen AL, Ueland PM. Folate - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10258. [PMID: 38187793 PMCID: PMC10770645 DOI: 10.29219/fnr.v67.10258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/29/2022] [Accepted: 09/27/2023] [Indexed: 01/09/2024] Open
Abstract
Folate is an essential micronutrient for normal development and metabolic function, and folate deficiency is associated with an increased risk of cancer, cardiovascular disease, mental dysfuntion and negative pregnancy outcomes. When estimating folate requirements, one must consider different bioavailability and functionality between synthetic folic acid and dietary folate, together with increased needs of folate in women of fertile age, pregnant and lactating women, preterm and small for gestational age weight infants and individuals who are homozygote for the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene polymorphism. In order to achieve an adequate metabolic status based on the metabolic marker total homocysteine, and not merely the absence of clinical signs of folate deficiency, the recommended intake of folate differs according to age, pregnancy and lactation. According to the World Health Organization, a decision limit for folate deficiency in adults is serum folate level below 10 nmol/L, and in women of fertile age a red blood cell folate level below 906 nmol/L in order to prevent neural tube defects. Qualified systematic reviews along with identified relevant literature have been used for this scoping review prepared for the Nordic Nutrition Recommendations 2023.
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Affiliation(s)
- Anne-Lise Bjørke-Monsen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Per Magne Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Wang J, Zhou J, Shao Z, Chen X, Yu Z, Zhao W. Association between serum uric acid and homocysteine levels among adults in the United States: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:599. [PMID: 38066416 PMCID: PMC10704836 DOI: 10.1186/s12872-023-03586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Many studies have shown that both elevated serum uric acid (SUA) levels and hyperhomocysteinemia are risk factors for atherosclerosis. However, the relationship between the two has not been thoroughly investigated. OBJECTIVE This study aimed to explore the possible link between SUA levels and homocysteine (Hcy) levels. METHODS In this cross-sectional study, 17,692 adults aged > 19 years in National Health and Nutrition Examination Survey from 1999 to 2006 were analyzed. Multivariable linear regression analysis was performed to assess the association between SUA and Hcy levels. In addition, smooth curve fitting (penalized spline method) and threshold effect analysis were performed. RESULTS Multivariable linear analysis showed that Hcy levels increased by 0.48 µmol/L (β = 0.48, 95%CI: 0.43-0.53) for every 1 mg/dL increase in SUA levels. We found a nonlinear relationship between SUA and Hcy levels. The results of threshold effect analysis showed that the inflection point for SUA levels was 7.1 mg/dL (β = 0.29, 95% CI: 0.23-0.36 and β = 1.05, 95% CI: 0.67-1.43 on the left and right sides of the inflection point, respectively). The p-values was less than 0.001 when using the log likelihood ratio test. This nonlinear relationship was also found in both sexes. The inflection point for SUA levels was 5.4 mg/dL in males and 7.3 mg/dL in females, respectively. CONCLUSIONS This cross-sectional study showed that the SUA levels were positively correlated with Hcy levels. And we found a nonlinear relationship between SUA and Hcy levels.
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Affiliation(s)
- Jiangsha Wang
- Department of Cardiology, Jiande Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Jie Zhou
- Center for General Practice Medicine, General Practice and Health Management Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China
| | - Zhengping Shao
- Department of Cardiology, Jiande Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, China
| | - Xi Chen
- Center for General Practice Medicine, General Practice and Health Management Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China
| | - Zhenhai Yu
- Department of Neurosurgery, De Qing People's Hospital, Deqing, Zhejiang, China.
| | - Wenyan Zhao
- Center for General Practice Medicine, General Practice and Health Management Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
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Uma Maheswari G, Yamini B, Dhandapani V, Almutairi BO, Arokiyaraj S, Karuppiah KM. Methylenetetrahydrofolate reductase polymorphisms in dental caries-induced pulp inflammation and regeneration of dentine-pulp complex: Future perspectives. Saudi Dent J 2023; 35:1029-1038. [PMID: 38170041 PMCID: PMC10759554 DOI: 10.1016/j.sdentj.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 01/05/2024] Open
Abstract
Dental caries (DC)-induced pulp infections usually undergo the common endodontic treatment, root canal therapy (RCT). Endodontically treated teeth are devitalized, become brittle and susceptible for re-infection which eventually results in dental loss. These complications arise because the devitalized pulp losses its ability for innate homeostasis, repair and regeneration. Therefore, restoring the vitality, structure and function of the inflamed pulp and compromised dentin have become the focal points in regenerative endodontics. There are very few evidences, so far, that connect methylenetetrahydrofolate reductase single nucleotide polymorphisms (MTHFR-SNPs) and dental disorders. However, the primary consequences of MTHFR-SNPs, in terms of excessive homocysteine and folate deficiency, are well-known contributors to dental diseases. This article identifies the possible mechanisms by which MTHFR-SNP-carriers are susceptible for DC-induced pulp inflammation (PI); and discusses a cell-homing based strategy for in vivo transplantation in an orthotopic model to regenerate the functional dentine-pulp complex which includes dentinogenesis, neurogenesis and vasculogenesis, in the SNP-carriers.
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Affiliation(s)
- G. Uma Maheswari
- Department of Cardiology, SRM Medical College Hospital and Research Center, SRM Institute of Science and Technology, Kattankulathur, 603 203 Chennai, Tamil Nadu, India
| | - B. Yamini
- Department of Cardiology, SRM Medical College Hospital and Research Center, SRM Institute of Science and Technology, Kattankulathur, 603 203 Chennai, Tamil Nadu, India
| | - V.E. Dhandapani
- Department of Cardiology, SRM Medical College Hospital and Research Center, SRM Institute of Science and Technology, Kattankulathur, 603 203 Chennai, Tamil Nadu, India
| | - Bader O. Almutairi
- Department of Zoology, College of Science, King Saud University, P.O.Box 2455, 11451 Riyadh, Saudi Arabia
| | - Selvaraj Arokiyaraj
- Department of Food Science & Biotechnology, Sejong University, Seoul 05006, Korea
| | - Kanchana M. Karuppiah
- Department of Medical Research, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, 603 203 Chennai, Tamil Nadu, India
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Bao H, Huang X, Li P, Sheng C, Zhang J, Wang Z, Song D, Hu L, Ding C, Cheng Z, Yao C, Chen G, Cui Y, Qin X, Tang G, Wang X, Huo Y, Cheng X, Wang J. Combined use of amlodipine and folic acid are significantly more efficacious than amlodipine alone in lowering plasma homocysteine and blood pressure among hypertensive patients with hyperhomocysteinemia and intolerance to ACEI: A multicenter, randomized, double-blind, parallel-controlled clinical trial. J Clin Hypertens (Greenwich) 2023; 25:689-699. [PMID: 37433173 PMCID: PMC10423753 DOI: 10.1111/jch.14697] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023]
Abstract
Hyperhomocysteinemia with hypertension can synergistically increase the risk of stroke. The China stroke primary prevention trial showed that combining 0.8 mg folic acid (FA) with angiotensin-converting enzyme inhibitor (ACEI) can effectively lower plasma total homocysteine (tHcy) and blood pressure (BP); and reduce first stroke risk by additional 21% compared to ACEI alone. However, intolerance to ACEI is common in Asians and amlodipine can be alternative. This is a multicenter, randomized, double-blind, parallel-controlled clinical trial (RCT) which evaluated whether amlodipine combined with FA is more efficacious than amlodipine alone in lowering tHcy and BP among Chinese hypertensive with hyperhomocysteinemia and intolerance to ACEI. 351 Eligible patients were randomly assigned by 1:1:1 ratio to receive amlodipine-FA tablet daily (amlodipine 5 mg/FA 0.4 mg, A group); amlodipine 5 mg/FA 0.8 mg tablet daily (B group); amlodipine 5 mg daily (C group, control group). Follow-up was conducted at 2, 4, 6, and 8 weeks. The primary outcome was efficacy of lowering both tHcy and BP at the end of 8-week treatment. Compared with C group, A group had a significantly higher rate of lowering both tHcy and BP (23.3% vs. 6.0%; Odds Ratio [OR], 8.68; 95% CI, 3.04-24.78, P < .001); B group also had a higher rate of lowering both tHcy and BP (20.3% vs. 6.0%; OR: 5.90; 95% CI, 2.11-16.47, P < .001). This RCT showed amlodipine combined with FA compared with amlodipine alone, each had significantly higher efficacy of lowering both tHcy and BP. No difference was found in BP-lowering and occurrence of adverse events between the three groups.
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Affiliation(s)
- Huihui Bao
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Xiao Huang
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Ping Li
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Changsheng Sheng
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jin Zhang
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhirong Wang
- Affiliated Hospital of Xuzhou Medical CollegeXuzhouChina
| | | | - Lihua Hu
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Congcong Ding
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Zaihua Cheng
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Chen Yao
- Peking University Clinical Research InstitutePeking University Health Science CenterBeijingChina
| | - Guangliang Chen
- College of Integrated Chinese and Western MedicineAnhui University of Chinese MedicineHefeiChina
| | - Yimin Cui
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Diseasethe State Key Laboratory for Organ Failure ResearchRenal DivisionNanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Genfu Tang
- School of Health AdministrationAnhui Medical UniversityHefeiChina
| | - Xiaobin Wang
- Department of PopulationFamily and Reproductive HealthJohns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Yong Huo
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Xiaoshu Cheng
- Department of CardiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Jiguang Wang
- The Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Flanagan A, Bradfield J, Kohlmeier M, Ray S. Need for a nutrition-specific scientific paradigm for research quality improvement. BMJ Nutr Prev Health 2023; 6:383-391. [PMID: 38618553 PMCID: PMC11009547 DOI: 10.1136/bmjnph-2023-000650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/23/2023] [Indexed: 04/16/2024] Open
Abstract
Nutrition science has been criticised for its methodology, apparently contradictory findings and generating controversy rather than consensus. However, while certain critiques of the field are valid and informative for developing a more cogent science, there are also unique considerations for the study of diet and nutrition that are either overlooked or omitted in these discourses. The ongoing critical discourse on the utility of nutrition sciences occurs at a time when the burden of non-communicable cardiometabolic disease continues to rise in the population. Nutrition science, along with other disciplinary fields, is tasked with producing a translational evidence-base fit for the purpose of improving population and individual health and reducing disease risk. Thus, an exploration of the unique methodological and epistemic considerations for nutrition research is important for nutrition researchers, students and practitioners, to further develop an improved scientific discipline for nutrition. This paper will expand on some of the challenges facing nutrition research, discussing methodological facets of nutritional epidemiology, randomised controlled trials and meta-analysis, and how these considerations may be applied to improve research methodology. A pragmatic research paradigm for nutrition science is also proposed, which places methodology at its centre, allowing for questions over both how we obtain knowledge and research design as the method to produce that knowledge to be connected, providing the field of nutrition research with a framework within which to capture the full complexity of nutrition and diet.
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Affiliation(s)
- Alan Flanagan
- Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, UK
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, NNEdPro, Cambridge, UK
| | - James Bradfield
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, NNEdPro, Cambridge, UK
- Department of Nutrition and Dietetics, King's College Hospital NHS Foundation Trust, London, UK
| | - Martin Kohlmeier
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, NNEdPro, Cambridge, UK
- School of Medicine, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - Sumantra Ray
- NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, NNEdPro, Cambridge, UK
- Department of Nutrition and Dietetics, King's College Hospital NHS Foundation Trust, London, UK
- School of Biomedical Sciences, Ulster University at Coleraine, Coleraine, UK
- Fitzwilliam College, University of Cambridge, Cambridge, UK
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8
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Lu XT, Wang YN, Mo QW, Huang BX, Wang YF, Huang ZH, Luo Y, Maierhaba W, He TT, Li SY, Huang RZ, Yang MT, Liu XZ, Liu ZY, Chen S, Fang AP, Zhang XG, Zhu HL. Effects of low-dose B vitamins plus betaine supplementation on lowering homocysteine concentrations among Chinese adults with hyperhomocysteinemia: a randomized, double-blind, controlled preliminary clinical trial. Eur J Nutr 2023; 62:1599-1610. [PMID: 36717385 PMCID: PMC9886420 DOI: 10.1007/s00394-023-03087-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/06/2023] [Indexed: 02/01/2023]
Abstract
PURPOSE To test the hypothesis that daily supplementation with low-dose B vitamins plus betaine could significantly reduce plasma homocysteine concentrations in Chinese adults with hyperhomocysteinemia and free from background mandatory folic acid fortification. METHODS One hundred apparently healthy adults aged 18-65 years with hyperhomocysteinemia were recruited in South China from July 2019 to June 2021. They were randomly assigned to either the supplement group (daily supplementation: 400 μg folic acid, 8 mg vitamin B6, 6.4 μg vitamin B12 and 1 g betaine) or the placebo group for 12 weeks. Fasting venous blood was collected at baseline, week 4 and week 12 to determine the concentrations of homocysteine, folate, vitamin B12 and betaine. Generalized estimation equations were used for statistical analysis. RESULTS Statistically significant increments in blood concentrations of folate, vitamin B12 and betaine after the intervention in the supplement group indicated good participant compliance. At baseline, there were no significant differences in plasma homocysteine concentration between the two groups (P = 0.265). After 12-week supplementation, compared with the placebo group, there was a significant reduction in plasma homocysteine concentrations in the supplement group (mean group difference - 3.87; covariate-adjusted P = 0.012; reduction rate 10.1%; covariate-adjusted P < 0.001). In the supplement group, the decreased concentration of plasma homocysteine was associated with increments of blood concentrations of both folate (β = -1.680, P = 0.004) and betaine (β = -1.421, P = 0.020) after 12 weeks of supplementation. CONCLUSIONS Daily supplementation with low-dose B vitamins plus betaine for 12 weeks effectively decreased plasma homocysteine concentrations in Chinese adults with hyperhomocysteinemia. TRIAL REGISTRATION This trial was registered at clinicaltrials.gov as NCT03720249 on October 25, 2018. Website: https://clinicaltrials.gov/ct2/show/NCT03720249 .
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Affiliation(s)
- Xiao-Ting Lu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Yi-Na Wang
- Department of VIP Medical Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong China
| | - Qi-Wan Mo
- Medical Examination Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong China
| | - Bi-Xia Huang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Yu-Fang Wang
- BYHEALTH Institute of Nutrition and Health, No.3 Kehui 3Rd Street, No.99 Kexue Avenue Central, Guangzhou, 510663 Guangdong China
| | - Zi-Hui Huang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Yan Luo
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Wusiman Maierhaba
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Tong-Tong He
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Shu-Yi Li
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Rong-Zhu Huang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Meng-Tao Yang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Xiao-Zhan Liu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China
| | - Zhao-Yan Liu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Si Chen
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Ai-Ping Fang
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Xu-Guang Zhang
- BYHEALTH Institute of Nutrition and Health, No.3 Kehui 3Rd Street, No.99 Kexue Avenue Central, Guangzhou, 510663 Guangdong China
| | - Hui-Lian Zhu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhong Shan Road 2, Guangzhou, 510080 Guangdong China ,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong China
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9
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Luo J, Chen X, Yang Y, Liu Y, Feng Y, Chen G. Association of MTHFR C667T Polymorphism, Homocysteine, and B Vitamins with Senile Cataract. J Nutr Sci Vitaminol (Tokyo) 2023; 69:136-144. [PMID: 37121723 DOI: 10.3177/jnsv.69.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Senile cataract has become the leading cause of visual impairment and even blindness in the world, but there are few reports on its relationship with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. This study is aimed to investigate the correlation between MTHFR gene polymorphisms or its enzyme metabolites and senile cataract. From January 2019 to June 2020, 663 patients with senile cataract at the Mianyang Central Hospital were enrolled as the observation group, and 646 healthy subjects were randomly selected as the control group. MTHFR gene polymorphisms (i.e., CC, CT, or TT genotypes) and serum homocysteine (HCY), folic acid (FOL), vitamin B12 (VitB12), and vitamin B6 (VitB6) levels were detected. The mutation rate of MTHFR C677T and HCY levels in the observation group were significantly higher than those in the control group, whereas FOL, VitB12, and VitB6 were significantly lower. With an increase in the MTHFR C677T mutation, HCY showed an upward trend, whereas FOL and VitB12 showed a decreasing trend in both the observation and control groups. Multiple logistic regression analysis showed that HCY and FOL were associated with senile cataract and MTHFR mutations; VitB12 was only associated with senile cataract. Compared to that with the CC genotype, CT and TT genotypes were associated with an increased senile cataract risk. Monitoring MTHFR gene polymorphisms and changes in serum HCY, FOL, and VitB12 levels could provide references in predicting senile cataract.
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Affiliation(s)
- Jun Luo
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Xiaohong Chen
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yuwei Yang
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yunbing Liu
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Yue Feng
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
| | - Gang Chen
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China
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10
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Ma L, Li J, Yuan Y, Chen W, Zhao J. Effect of methylenetetrahydrofolate reductase C677T polymorphism on serum folate but not vitamin B12 levels in patients with H-type hypertension. Mol Biol Rep 2022; 49:9535-9541. [PMID: 35951145 DOI: 10.1007/s11033-022-07844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Hyperhomocysteinemia (HHcy) is a common complication in Chinese hypertensive patients and associated with methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, folate, and vitamin B12 (Vit B12) status. This study evaluated the associations of MTHFR C677T polymorphism, folate, and Vit B12 with H-type hypertension. METHODS AND RESULTS 887 eligible patients with essential hypertension were included. Patients were divided into two groups according to the Hcy level, the H-type hypertension group and the normal hypertension group. Related risk factors such as MTHFR polymorphism, folate and Vit B12 status were analyzed in the two groups. Age, gender, SBP, DBP, MTHFR C677T genotype, folate and Vit B12 differed significantly between H-type hypertension and normal hypertension groups (P < 0.05). MTHFR 677TT variant, gender, folate, and Vit B12 were independent risk factors for the occurrence of H-type hypertension. The risk for TT carriers was 8 times higher than that of CC and CT carriers [OR (95% CI) 8.248 (5.274-12.899)]. Male patients had almost fivefold higher odds than female patients [OR (95% CI) 4.923 (2.741-8.842)]. Folate level of patients with H-type hypertension decreased with the C to T substitution of MTFHR C677T gene (P < 0.05), while Vit B12 level was not associated with the gene (P > 0.05). CONCLUSIONS MTHFR 677TT variant, gender, folate, and Vit B12 were risk factors for the occurrence of H-type hypertension. Folate but not Vit B12 was associated with MTFHR C677T polymorphism in patients with H-type hypertension. Accordingly, the above factors may be considered in the prevention and treatment of hypertension.
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Affiliation(s)
- Lijuan Ma
- Department of Pharmacy, Xinjiang Medical University Affiliated First Hospital, Ürümqi, 830011, China.,The Precision Medicine Center of Xinjiang Medical University, Ürümqi, 830011, China
| | - Jing Li
- Department of Pharmacy, Xinjiang Medical University Affiliated First Hospital, Ürümqi, 830011, China
| | - Yuan Yuan
- Department of Pharmacy, Xinjiang Medical University Affiliated First Hospital, Ürümqi, 830011, China.,The Precision Medicine Center of Xinjiang Medical University, Ürümqi, 830011, China
| | - Wenwen Chen
- Department of Pharmacy, Xinjiang Medical University Affiliated First Hospital, Ürümqi, 830011, China
| | - Jun Zhao
- Department of Pharmacy, Xinjiang Medical University Affiliated First Hospital, Ürümqi, 830011, China. .,The Precision Medicine Center of Xinjiang Medical University, Ürümqi, 830011, China.
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11
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Cheng Y, Liu S, Chen D, Yang Y, Liang Q, Huo Y, Zhou Z, Zhang N, Wang Z, Liu L, Song Y, Liu X, Duan Y, Liang X, Hou B, Wang B, Tang G, Qin X, Yan F. Association between serum 5-methyltetrahydrofolate and homocysteine in Chinese hypertensive participants with different MTHFR C677T polymorphisms: a cross-sectional study. Nutr J 2022; 21:29. [PMID: 35562805 PMCID: PMC9102656 DOI: 10.1186/s12937-022-00786-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background and aims Clarifying the association between 5-methyltetrahydrofolate and homocysteine and the effect pattern of methylene tetrahydrofolate reductase (MTHFR C677T) may contribute to the management of homocysteine and may serve as a significant reference for a randomized controlled trial of 5-methyltetrahydrofolate intervention. This study aimed to reveal the association between these two biochemical indices. Methods Study population was drawn from the baseline data of the China Stroke Primary Prevention Trial (CSPPT), including 2328 hypertensive participants. 5-methyltetrahydrofolate and homocysteine were determined by stable-isotope dilution liquid chromatography-tandem mass spectrometry and automatic clinical analyzers, respectively. MTHFR C677T polymorphisms were detected using TaqMan assay. Multiple linear regression was performed to evaluate the association between serum 5-methyltetrahydrofolate and homocysteine. Results There was a significant inverse association between 5-methyltetrahydrofolate and homocysteine when 5-methyltetrahydrofolate was ≤ 10 ng/mL, and this association was modified by MTHFR C677T (per 1-ng/mL increment; All: β = − 0.50, P < 0.001; CC: β = − 0.14, P = 0.087; CT: β = − 0.20, P = 0.011; TT: β = − 1.19, P < 0.001). Moreover, the decline in trend in genotype TT participants was stronger than in genotype CC participants (P for difference < 0.001) and genotype CT participants (P for difference < 0.001), while there was no significant difference between genotype CC and genotype CT participants (P for difference = 0.757). Conclusions Our data showed a non-linear association between serum homocysteine and 5-methyltetrahydrofolate among Chinese hypertensive adults, however, it could be inversely linearly fitted when serum 5-methyltetrahydrofolate was ≤ 10 ng/mL, and this association was modified by MTHFR C677T. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00786-w.
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Affiliation(s)
- Yu Cheng
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Shuai Liu
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Duo Chen
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Yiman Yang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Qiongyue Liang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Ya Huo
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China
| | - Ziyi Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhuo Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xiangyi Liu
- BeiJing TongRen Hospital, CMU, Beijing, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, China.,Department of Clinical Laboratory, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiuwen Liang
- China Mongolia Hospital of Hulunbuir, Inner Mongolia, China
| | - Bingjie Hou
- The Fourth Central Hospital of Baoding City, Hebei, Baoding, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China.,Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Genfu Tang
- School of Health Administration, Anhui Medical University, Hefei, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510000, China.
| | - Fangrong Yan
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210000, China.
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12
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Using the optimal method-explained variance weighted genetic risk score to predict the efficacy of folic acid therapy to hyperhomocysteinemia. Eur J Clin Nutr 2022; 76:943-949. [PMID: 35001080 DOI: 10.1038/s41430-021-01055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genetic risk score (GRS) is a useful way to explore genetic architectures and the relationships of complex diseases. Several studies had revealed many single nucleotide polymorphisms (SNPs) associated with the efficacy of folic acid treatment to hyperhomocysteinemia (HHcy). METHODS We aimed to construct and screen out the optimal predictive model based on four GRSs and traditional risk factors. Four GRSs enrolled four SNPs (MTHFR rs1801131, MTHFR rs1801133, MTRR rs1801394, BHMT rs3733890) were presented as follows: (a) simple count genetic risk score (SC-GRS), (b) direct logistic regression genetic risk score (DL-GRS), (c) polygenic genetic risk score (PG-GRS), and (d) explained variance weighted genetic risk score (EV-GRS). We performed a prospective cohort study including 638 HHcy patients. Then we evaluated the associations of four GRSs with folic acid's efficacy and the performance of four GRSs. RESULTS Four GRSs were independently associated with efficacy of treatment (p < 0.05). When combining GRSs with traditional risk factors, the AUC of the four models were all above 0.900 in the training set (Tradition + SC-GRS: 0.909, Tradition + DL-GRS: 0.909, Tradition + PG-GRS: 0.904, Tradition + EV-GRS: 0.910). And EV-GRS got the highest AUC. When evaluating the models in the testing set, we got the same conclusion that EV-GRS was optimal among four GRSs with the highest AUC (0.878) and the highest increase of AUC (0.008). CONCLUSION A more precise predictive model combing the optimal GRS with traditional risk factors was constructed to predict the efficacy of folic acid therapy to HHcy.
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13
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You M, Zhou X, Yin W, Wan K, Zhang W, Li C, Li M, Zhu W, Zhu X, Sun Z. The Influence of MTHFR Polymorphism on Gray Matter Volume in Patients With Amnestic Mild Cognitive Impairment. Front Neurosci 2021; 15:778123. [PMID: 34916904 PMCID: PMC8670096 DOI: 10.3389/fnins.2021.778123] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/05/2021] [Indexed: 12/17/2022] Open
Abstract
The methylenetetrahydrofolate reductase (MTHFR) gene has been associated with Alzheimer's disease (AD) pathogenesis. Amnestic mild cognitive impairment (aMCI) represents a prodromal stage of dementia and involves a high risk of progression into AD. Although the effects of the apolipoprotein E (APOE) gene on structural alterations in aMCI have been widely investigated, the effects of MTHFR C677T and interaction effects of MTHFR × APOE genotypes on gray matter atrophy in aMCI remain largely unknown. In the present study, 60 aMCI patients and 30 healthy controls were enrolled, and voxel-based morphometry analysis was performed to inspect the effects of diagnosis, different genotypes, and their interactions on gray matter atrophy. The results showed that aMCI patients had significant gray matter atrophy involving the bilateral hippocampus, the right parahippocampal gyrus, and the left superior temporal gyrus compared with healthy controls. Besides, a substantial reduction in gray matter volume was observed in the right hippocampus region in APOE ε4 carriers from the aMCI group, compared with APOE ε4 non-carriers. A significant interaction was found between diagnosis and MTHFR C677T genotype on the right precuneus in healthy controls and aMCI patients not carrying APOE ε4 allele. Our findings may provide new evidence substantiating the genetic effects of MTHFR C677T on brain structural alternation in patients with aMCI.
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Affiliation(s)
- Mengzhe You
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xia Zhou
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenwen Yin
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Wan
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Zhang
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chenchen Li
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mingxu Li
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenhao Zhu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhongwu Sun
- Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, China
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14
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Effect of age stratification on the association between carotid intima-media thickness and cognitive impairment in Chinese hypertensive patients: new insight from the secondary analysis of the China Stroke Primary Prevention Trial (CSPPT). Hypertens Res 2021; 44:1505-1514. [PMID: 34493836 DOI: 10.1038/s41440-021-00743-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
The current study aimed to explore the association between carotid intima-media thickness (CIMT) and cognitive function assessed by the Mini-Mental State Examination (MMSE) and to examine possible effect modifiers in hypertensive patients. A total of 14,322 hypertensive participants (mean age 64.2 ± 7.4 years; 40.9% male) from the China Stroke Primary Prevention Trial (CSPPT) were included in the final analysis. CIMT was measured by ultrasound, and data were collected at the last follow-up visit; MMSE was used to evaluate cognitive function. Nonparametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the relationship between the CIMI and cognitive function and effect modification. The mean CIMT was 0.74 ± 0.11 mm, and the mean MMSE score was 23.5 ± 4.8. There was a significant interaction (P interaction < 0.05) in both male and female populations stratified by age (<60 vs. ≥60 years), and higher CIMT was significantly associated with decreased MMSE scores only in participants aged ≥60 years (male: β = -2.29, 95% CI -3.23 to -1.36; female: β = -1.96, 95% CI -2.97 to -0.95). Males with abnormal HDL-C showed a stronger negative association (β = -3.16, 95% CI -4.85 to -1.47) than those with normal HDL-C (normal vs. abnormal, P for interaction = 0.004). We observed that increased CIMT was significantly associated with cognitive impairment in the hypertensive population, especially among individuals with an age greater than 60 years and HDL-C deficiency. Overall, upon diagnosis of hypertension, treatment should start at the earliest opportunity to prevent end-organ damage and cognitive decline.
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15
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Li CX, Liu YG, Che YP, Ou JL, Ruan WC, Yu YL, Li HF. Association Between MTHFR C677T Polymorphism and Susceptibility to Autism Spectrum Disorders: A Meta-Analysis in Chinese Han Population. Front Pediatr 2021; 9:598805. [PMID: 33777860 PMCID: PMC7987783 DOI: 10.3389/fped.2021.598805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/08/2021] [Indexed: 12/22/2022] Open
Abstract
Prior studies have examined the influence of MTHFR C677T on autism susceptibility, however, there are no consensus conclusions and specific analyses of a Chinese population. This meta-analysis included a false-positive report probability (FPRP) test to comprehensively evaluate the association of MTHFR C677T polymorphism with autism susceptibility among a Chinese Han population. A large-scale literature retrieval was conducted using various databases including PubMed, Embase, Wan Fang, and the Chinese National Knowledge Infrastructure (CNKI) up to July 31, 2020, with a total of 2,258 cases and 2,073 controls included. The strength of correlation was assessed by odds ratios (ORs) and 95% confidence intervals (95% CIs). MTHFR C677T showed a significant correlation with increased ASD susceptibility under all genetic models (T vs. C, OR = 1.89, 95% CI 1.28 to 2.79; TT vs. CC: OR = 2.44, 95% CI 1.43 to 4.15; CT vs. CC, OR = 1.73; 95% CI 1.19 to 2.51; CT + TT vs. CC: OR = 2.03, 95% CI 1.31 to 3.15; TT vs. CT + CC, OR = 1.95, 95% CI 1.21 to 3.13). Stratification analysis by region also revealed a consistent association in the Northern Han subgroup, but not in the Southern Han subgroup. Pooled minor allele frequency (MAF) of 30 studies were 45% in Northern Han and 39% in Southern Han. To avoid a possible "false positive report," we further investigated the significant associations observed in the present meta-analysis using the FPRP test, which consolidated the results. In conclusion, MTHFR C677T polymorphism is associated with the increased risk of autism in China, especially in Northern Han. For those mothers and children who are generally susceptible to autism, prenatal folate and vitamin B12 may reduce the risk that children suffer from autism, especially in Northern Han populations. In the future, more well-designed studies with a larger sample size are expected.
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Affiliation(s)
- Chen-Xi Li
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yi-Guang Liu
- Department of Linguistics, Zhejiang University, Hangzhou, China
| | - Yue-Ping Che
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian-Lin Ou
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wen-Cong Ruan
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yong-Lin Yu
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hai-Feng Li
- Department of Rehabilitation, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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16
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Wang Y, Fan X, Fan B, Jiang K, Zhang H, Kang F, Su H, Gu D, Li S, Lin S. Scutellarin Reduce the Homocysteine Level and Alleviate Liver Injury in Type 2 Diabetes Model. Front Pharmacol 2020; 11:538407. [PMID: 33362535 PMCID: PMC7759645 DOI: 10.3389/fphar.2020.538407] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022] Open
Abstract
Scutellarin (SCU) is an active ingredient extracted from Erigeron breviscapus (Vaniot) Hand.-Mazz. Its main physiological functions are anti-inflammatory and antioxidant. In this study, we established a STZ-induced model of type 2 diabetes (T2DM) and a homocysteine (Hcy)-induced apoptosis model of LO2 to investigate whether SCU can alleviate liver damage by regulating Hcy in type 2 diabetes. Biochemical analysis indicated that SCU could improve the lipid metabolism disorder and liver function in diabetic rats by downregulating the levels of triglycerides (TG), cholesterol (CHO), low-density lipoprotein (LDL), alanine transaminase (ALT) and aspartate transaminase (AST), and by upregulating the level of high-density lipoprotein (HDL). Interestingly, SCU also could down-regulate the levels of Hcy and insulin and enhance the ability of type 2 diabetic rats to regulate blood glucose. Mechanistically, our results indicated that SCU may control the level of Hcy through regulating the levels of β-Cystathionase (CBS), γ-Cystathionase (CSE) and 5,10-methylenetetrahydrofolate (MTHFR) in liver tissue, and up-regulate folic acid, VitB6 and VitB12 levels in serum. Furthermore, SCU inhibits apoptosis in the liver of T2DM rats and in cultured LO2 cells treated with Hcy. Together, our findings suggest that SCU may alleviate the liver injury thorough downregulating the level of Hcy in T2DM rats.
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Affiliation(s)
- Yiyu Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China.,Department of Clinical Laboratory, Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan, China
| | - Xiaoming Fan
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China
| | - Biao Fan
- The Center of Basic Experiment, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Kerong Jiang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Haoxin Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Feng Kang
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Hui Su
- Department of Pharmacology, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Danshan Gu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China
| | - Shude Li
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Kunming Medical University, Kunming, China.,Yunnan Province Key Laboratory for Nutrition and Food Safety in Universities, Kunming, China
| | - Shaofang Lin
- Department of Geriatrics, Gan Mei Hospital, The First People Hospital of Kunming City, Kunming, China
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17
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Ding C, Bi C, Lin T, Hu L, Huang X, Liu L, Liu C, Song Y, Tang G, Wang B, Qin X, Yang Y, Zhang Y, Li J, Li P, Bao H, Wang X, Xu X, Huo Y, Cheng X. Serum folate modified the association between low-density lipoprotein cholesterol and carotid intima-media thickness in Chinese hypertensive adults. Nutr Metab Cardiovasc Dis 2020; 30:2303-2311. [PMID: 32912792 DOI: 10.1016/j.numecd.2020.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 06/02/2020] [Accepted: 07/14/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS While folate is known for its importance in cardiovascular health, it is unknown whether folate status can modify the association between low-density lipoprotein cholesterol (LDL-C) and carotid intima-media thickness (CIMT). We aimed to investigate this question in a Chinese hypertensive population, who are at high-risk of low folate and atherosclerosis. METHODS AND RESULTS This report included 14,970 hypertensive adults (mean age 64.5 years; 40.3% male) from the China Stroke Primary Prevention Trial (CSPPT) and analyzed the fasting serum LDL-C and folate, and CIMT data obtained at the last follow-up visit. LDL-C was calculated using the Friedewald equation. Serum folate levels were measured by chemiluminescent immunoassay. CIMT was measured by ultrasound. Non-parametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the LDL-C-CIMI relationship and effect modification by folate. Consistent with graphic plots, multivariate linear regression showed that LDL-C levels were independently and positively associated with CIMT (β = 7.69, 95%CI: 5.76-9.62). More importantly, the relationship between LDL-C and CIMT was significantly attenuated with increasing serum folate levels (1st tertile: β = 10.06, 95%CI: 6.67-13.46; 2nd tertile: β = 6.81, 95%CI: 3.55-10.07; 3rd tertile: β = 5.96, 95%CI: 2.55-9.36; P-interaction = 0.045). Subgroup analyses showed the association between LDL-C and CIMT across serum folate tertiles was robust among various strata (all P-interaction >0.05). CONCLUSIONS Among Chinese hypertensive adults, the serum folate levels could modify the association between LDL-C and CIMT. Our findings, if further confirmed, have important clinical implications.
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Affiliation(s)
- Congcong Ding
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Chonglei Bi
- People's Hospital of Rongcheng, Shandong Province, China
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | | | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China; Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Genfu Tang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, China; Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China; Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Institute of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Yang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiping Xu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China; Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Institute of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
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Liu L, Huang X, Wang B, Song Y, Lin T, Zhou Z, Wang Z, Wei Y, Guo H, Chen P, Yang Y, Ling W, Li Y, Qin X, Tang G, Liu C, Li J, Zhang Y, Zalloua PA, Wang X, Huo Y, Zhang H, Xu X. Vitamin B 12 and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT). BMJ Open Diabetes Res Care 2020; 8:8/1/e001423. [PMID: 33023897 PMCID: PMC7539576 DOI: 10.1136/bmjdrc-2020-001423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Previous studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12 with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12-diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses. RESEARCH DESIGN AND METHODS This report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit. RESULTS At baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12 deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12 levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12 and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12 measurements, we found a positive association between an increase in vitamin B12 and an increase in FBG. CONCLUSIONS In this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12 and its longitudinal trajectory in order to better elucidate the role of vitamin B12 in the development of diabetes. Such findings would have important clinical and public health implications.
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Affiliation(s)
- Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiao Huang
- Department of Cardiology, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tengfei Lin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ziyi Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Zhuo Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Yaping Wei
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Huiyuan Guo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, Guangdong, China
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, China
| | - Wenhua Ling
- Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, China
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Youbao Li
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
| | - Genfu Tang
- Institute of Biomedicine, Anhui Medical University, Hefei, Anhui, China
| | | | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Pierre A Zalloua
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Hao Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
- National Clinical Research Study Center for Kidney Disease, the State Key Laboratory for Organ Failure Research, Renal Division, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
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19
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Zhan B, Xu Z, Zhang Y, Wan K, Deng H, Wang D, Bao H, Wu Q, Hu X, Wang H, Huang X, Cheng X. Nicorandil reversed homocysteine-induced coronary microvascular dysfunction via regulating PI3K/Akt/eNOS pathway. Biomed Pharmacother 2020; 127:110121. [PMID: 32407984 DOI: 10.1016/j.biopha.2020.110121] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/18/2020] [Accepted: 03/27/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Nicorandil exerts a protective effect against coronary microvascular dysfunction in acute myocardial infarction (AMI) patients. However, the mechanism and effect of nicorandil in hyperhomocysteinemia (HHcy) AMI patients remain unclear. METHODS C57/BL6 mice with mild to moderate HHcy and human coronary artery endothelial cells (HCAECs) cotreated with HHcy (1 mmol/L) for 24 h and hypoxia for 6 h were selected as models. Small animal ultrasound detection was used to compare cardiac function. CD31 immunofluorescence staining and tomato lectin staining were used to assess the number of microcirculation changes in vivo. MTT, tube formation and western blotting assays were used to evaluate the effect of nicorandil on HCAECs and the PI3K/Akt/eNOS pathway. RESULTS The results showed that nicorandil improved cell viability and p-PI3K/PI3K, p-Akt/Akt, and p-eNOS/eNOS expression in the vitro HHcy and hypoxia models. The beneficial effects of nicorandil on HCAECs could be inhibited by the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 and the nitric oxide synthase (NOS) inhibitor L-NAME. In vivo, nicorandil improved the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) in the post-HHcy + MI model, and the levels of CD31 and tomato lectin expression were higher in the nicorandil treatment group. The effectiveness of nicorandil was inhibited in the PI3K and L-NAME groups. CONCLUSION The results suggest that nicorandil improves Hcy-induced coronary microvascular dysfunction through the PI3K/Akt/eNOS signalling pathway.
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Affiliation(s)
- Biming Zhan
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China
| | - Zongyu Xu
- Department of Cardiology, Huangpu Branch of the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiaotong University, China
| | - Yang Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Nanchang University, China
| | - Kefei Wan
- Clinical Medicine, Medical College of Nanchang University, China
| | - Hanyue Deng
- Clinical Medicine, Medical College of Nanchang University, China
| | - Dimeng Wang
- Clinical Medicine, Medical College of Nanchang University, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China
| | - Qinghua Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China
| | - Xiaohong Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China
| | - Hong Wang
- Center for Metabolic Disease Research, Department of Pharmacology Lewis Katz School of Medicine, Temple University, 3500 Broad Street, Philadelphia, PA, 19140, United States
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, China.
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Zhao Q, Li D, Huang X, Ren B, Yue L, Du B, Zhang C, Zhang W. Identifying gene-environment interactions on the efficacy of folic acid therapy for hyperhomocysteinemia based on prediction model. Nutr Res 2020; 77:54-61. [PMID: 32320840 DOI: 10.1016/j.nutres.2020.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/24/2020] [Accepted: 03/06/2020] [Indexed: 11/18/2022]
Abstract
Various genetic and environmental factors or their interactions may result in the failure of folic acid therapy for hyperhomocysteinemia (HHcy). We hypothesized that an optimal predictive model of gene-environment interactions could be constructed to predict the efficacy of folic acid therapy in HHcy. A prospective cohort study of 638 HHcy patients was performed. The patients were treated with oral folic acid (5 mg/d) for 90 days. We used conditional inference tree model to stratify the failure risk of folic acid therapy synthesizing information from a weighted genetic risk score (wGRS) and environmental exposures, simultaneously interpreting the gene-environment interaction network in predicting the efficacy of HHcy. We detected high-order interactions between medical history of stroke, coronary heart disease (CHD), wGRS, and baseline total homocysteine (tHcy) on the failure risk of folic acid therapy. The wGRS in fourth quartile had 3.73-fold increased failure risk of folic acid treatment (odds ratio = 3.73, 95% confidence interval: 1.47-9.45). Stroke was identified as the key discriminator among the variables examined. A total of 3.3% of participants in failure group were at the lowest failure risk of folic acid therapy (nonstroke, non-CHD, baseline tHcy ≤ 31.1 μmol/L, wGRS ≤ 1.05). Individuals with stroke but with wGRS > 1.05 were at the highest failure risk of folic acid therapy (91.0% of participants in failure group). Medical history of stroke, CHD, wGRS, and baseline tHcy were consistently identified as significant risk factors for the failure risk of folic acid therapy. The multiple interactions between genetic and environmental factors can be visually presented via the conditional inference tree model.
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Affiliation(s)
- Qinglin Zhao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Dankang Li
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Xiaowen Huang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Bingnan Ren
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Limin Yue
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Binghui Du
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China
| | - Chengda Zhang
- Department of International Medicine, Beaumont Health System, Royal Oak, MI, 48073, United States
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001,Henan, People's Republic of China.
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21
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Imbalance of Homocysteine and H 2S: Significance, Mechanisms, and Therapeutic Promise in Vascular Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:7629673. [PMID: 31885816 PMCID: PMC6893243 DOI: 10.1155/2019/7629673] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/16/2019] [Indexed: 12/28/2022]
Abstract
While the role of hyperhomocysteinemia in cardiovascular pathogenesis continuously draws attention, deficiency of hydrogen sulfide (H2S) has been growingly implicated in cardiovascular diseases. Generation of H2S is closely associated with the metabolism of homocysteine via key enzymes such as cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). The level of homocysteine and H2S is regulated by each other. Metabolic switch in the activity of CBS and CSE may occur with a resultant operating preference change of these enzymes in homocysteine and H2S metabolism. This paper presented an overview regarding (1) linkage between the metabolism of homocysteine and H2S, (2) mutual regulation of homocysteine and H2S, (3) imbalance of homocysteine and H2S in cardiovascular disorders, (4) mechanisms underlying the protective effect of H2S against homocysteine-induced vascular injury, and (5) the current status of homocysteine-lowering and H2S-based therapies for cardiovascular disease. The metabolic imbalance of homocysteine and H2S renders H2S/homocysteine ratio a potentially reliable biomarker for cardiovascular disease and development of drugs or interventions targeting the interplay between homocysteine and H2S to maintain the endogenous balance of these two molecules may hold an even bigger promise for management of vascular disorders than targeting homocysteine or H2S alone.
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22
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Prediction model for the efficacy of folic acid therapy on hyperhomocysteinaemia based on genetic risk score methods. Br J Nutr 2019; 122:39-46. [PMID: 30935434 DOI: 10.1017/s0007114519000783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
No risk assessment tools for the efficacy of folic acid treatment for hyperhomocysteinaemia (HHcy) have been developed. We aimed to use two common genetic risk score (GRS) methods to construct prediction models for the efficacy of folic acid therapy on HHcy, and the best gene-environment prediction model was screened out. A prospective cohort study enrolling 638 HHcy patients was performed. We used a logistic regression model to estimate the associations of two GRS methods with the efficacy. Performances were compared using area under the receiver operating characteristic curve (AUC). The simple count genetic risk score (SC-GRS) and weighted genetic risk score (wGRS) were found to be independently associated with the efficacy of folic acid treatment for HHcy. Using the SC-GRS, per risk allele increased with a 1·46-fold increased failure risk (P < 0·001) after adjustment for traditional risk factors, including age, sex, BMI, smoking, alcohol consumption, history of diabetes, history of hypertension, history of hyperlipidaemia, history of stroke and history of CHD. When used the wGRS, the association was strengthened (OR = 2·08, P < 0·001). Addition of the SC-GRS and wGRS to the traditional risk model significantly improved the predictive ability by AUC (0·859). A precise gene-environment predictive model with good performance was developed for predicting the treatment failure rate of folic acid therapy for HHcy.
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23
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Xu Y, Zhang N, Xu S, Xu H, Chen S, Xia Z. Effects of phenytoin on serum levels of homocysteine, vitamin B12, folate in patients with epilepsy: A systematic review and meta-analysis (PRISMA-compliant article). Medicine (Baltimore) 2019; 98:e14844. [PMID: 30896627 PMCID: PMC6709116 DOI: 10.1097/md.0000000000014844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND To determine the influence of phenytoin (PHT) monotherapy on the serum levels of homocysteine (Hcy), folate and vitamin B12 in patients with epilepsy. METHODS Literature retrieval was performed through PubMed, Web of Science, Embase, Cochrane Library, Chinese Wanfang Data, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database databases as of the end of March 2018. Pooled weighted mean difference (WMD) and 95% CIs were calculated using a random effect model. RESULTS A total of ten eligible studies were identified. The result revealed that the serum level of homocysteine in PHT-treated patients with epilepsy was significantly higher than that in control group (WMD = 8.47, 95% CI: 6.74 to 10.20, P < .001). In addition, the serum levels of folate (WMD = -3.51, 95% CI: -4.20 to -2.83, P < .001) and vitamin B12 (WMD = -62.23, 95% CI: -83.27 to -41.19, P < .001) were decreased significantly compared with the control group. CONCLUSIONS Our meta-analysis indicates that PHT monotherapy is associated with the increase in the serum homocysteine levels and decreased levels of folate and vitamin B12, and hyperhomocysteinaemia may contribute to the acceleration of the atherosclerotic process. Therefore, the patients under these medications should be monitored plasma homocysteine.
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Affiliation(s)
- Yubin Xu
- Department of Pharmaceutics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang
| | - Na Zhang
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Shanshan Xu
- Department of Pharmaceutics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang
| | - Hongyan Xu
- Department of Pharmaceutics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang
| | - Saizhen Chen
- Department of Pharmaceutics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang
| | - Zhelin Xia
- Department of Pharmaceutics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang
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24
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Ma L, Liu Q, Jiang Y, Zhao H, Zhao T, Cao Y, Li P, Niu W. Genetically elevated circulating homocysteine concentrations increase the risk of diabetic kidney disease in Chinese diabetic patients. J Cell Mol Med 2019; 23:2794-2800. [PMID: 30729677 PMCID: PMC6433716 DOI: 10.1111/jcmm.14187] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/16/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022] Open
Abstract
Diabetic kidney disease (DKD) is a devastating and frequent complication of diabetes mellitus. Here, we first adopted methylenetetrahytrofolate reductase (MTHFR) gene C677T polymorphism as an instrument to infer the possible causal relevance between circulating homocysteine and DKD risk in a Chinese population and next attempted to build a risk prediction model for DKD. This is a hospital‐based case‐control association study. Total 1107 study participants were diagnosed with type 2 diabetes mellitus, including 547 patients with newly diagnosed and histologically confirmed DKD. MTHFR gene C677T polymorphism was determined using the TaqMan method. Carriers of 677TT genotype (14.55 μmol/L) had significantly higher homocysteine concentrations than carriers of 677CT genotype (12.88 μmol/L) (P < 0.001). Carriers of 677TT genotype had a 1.57‐fold increased risk of DKD (odds ratio: 1.57, 95% CI: 1.21‐2.05, P = 0.001) relative to carriers of 677CT genotype after adjusting for confounders. Mendelian randomization analysis revealed that the odds ratio for DKD relative to diabetes mellitus per 5 μmol/L increment of circulating homocysteine concentrations was 3.86 (95% confidence interval: 1.21‐2.05, P < 0.001). In the Logistic regression analysis, hypertension, homocysteine and triglyceride were significantly associated with an increased risk of DKD and they constituted a risk prediction model with good test performance and discriminatory capacity. Taken together, our findings provide evidence that elevated circulating homocysteine concentrations were causally associated with an increased risk of DKD in Chinese diabetic patients.
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Affiliation(s)
- Liang Ma
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Qian Liu
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Yongwei Jiang
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Hailing Zhao
- Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Institute of Clinical Medical Science, Beijing, China
| | - Tingting Zhao
- Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Institute of Clinical Medical Science, Beijing, China
| | - Yongtong Cao
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Ping Li
- Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Institute of Clinical Medical Science, Beijing, China
| | - Wenquan Niu
- BioBank Center, China-Japan Friendship Hospital, Institute of Clinical Medical Science, Beijing, China
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25
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Hankey GJ. B vitamins for stroke prevention. Stroke Vasc Neurol 2018; 3:51-58. [PMID: 30022794 PMCID: PMC6047336 DOI: 10.1136/svn-2018-000156] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/24/2022] Open
Abstract
Supplementation with B vitamins (vitamin B9(folic acid), vitamin B12 and vitamin B6) lowers blood total homocysteine (tHcy) concentrations by about 25% and reduces the relative risk of stroke overall by about 10% (risk ratio (RR) 0.90, 95% CI 0.82 to 0.99) compared with placebo. Homocysteine-lowering interventions have no significant effect on myocardial infarction, death from any cause or adverse outcomes. Factors that appear to modify the effect of B vitamins on stroke risk include low folic acid status, high tHcy, high cyanocobalamin dose in patients with impaired renal function and concurrent antiplatelet therapy. In regions with increasing levels or established policies of population folate supplementation, evidence from observational genetic epidemiological studies and randomised controlled clinical trials is concordant in suggesting an absence of benefit from lowering of homocysteine with folic acid for prevention of stroke. Clinical trials indicate that in countries which mandate folic acid fortification of food, folic acid supplementation has no significant effect on reducing stroke risk (RR 1.05, 95% CI 0.90 to 1.23). However, in countries without mandatory folic acid food fortification, folic acid supplementation reduces the risk of stroke by about 15% (RR 0.85, 95% CI 0.77 to 0.94). Folic acid alone or in combination with minimal cyanocobalamin (≤0.05 mg/day) is associated with an even greater reduction in risk of future stroke by 25% (RR 0.75, 95% CI 0.66 to 0.86), whereas the combination of folic acid and a higher dose of cyanocobalamin (≥0.4 mg/day) is not associated with a reduced risk of future stroke (RR 0.95, 95% CI 0.86 to 1.05). The lack of benefit of folic acid plus higher doses of cyanocobalamin (≥0.4 mg/day) was observed in trials which all included participants with chronic kidney disease. Because metabolic B12 deficiency is very common and usually not diagnosed, future randomised trials of homocysteine-lowering interventions for stroke prevention should probably test a combination of folic acid and methylcobalamin or hydroxocobalamin instead of cyanocobalamin, and perhaps vitamin B6.
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Affiliation(s)
- Graeme J Hankey
- UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Department of Neurology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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